My cardiologist is concerned that having 12 hour episodes of afib every 12 days will restructure (damage) my heart. My EP does not seem that worried, however.
Apparently, statistically, I can expect to lose 2.6 years off of my life expectancy, which seems a bit paradoxical, because if I expect to lose 2.6 years then that is my life expectancy...
I know it means had I not had Afib, but I still find such statistics pretty meaningless.
I just wanted to know what others have been told.
Thanks,
Fibnum
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fibnum
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I have always been told that provided rate is well controlled (ie kept under 100-110) during events and anticoagulation taken where appropriate there is no loss of life expectancy.
Thanks, Bob, I take a small dose of metoprolol daily (25 mg), and I do not usually go over 100 initially, and my heart slows down soon. BP tends to be fine throughout the 12 hours, more or less, that I am in Afib. I think each case has to be considered based on the individual's Afib symptoms and response, thanks for seconding that. Maybe I will only lose a couple of weeks!
Not strictly true, although the usual consensus is that the AF alone won’t necessarily foreshorten your life. We are all individuals and the effects of AF can be widely different for each person. Long term permanent AF can cause Bi Atrial enlargement which can result in MR and TR which could require surgical intervention for repair or replacement. This impacts on the performance of the heart and can influence long term prognosis and life expectancy. This is a direct result of the ‘quivering’ of the atria in AF even though rate maybe controlled. It is not possible to get an absolute rate when in AF even with control medication because it fluctuates continuously with the erratic beating of the atria. AF is not a ‘one fits all condition’ but rate control and living your life fully day by day is so very important.
Very good! They are both standard abbreviations like AF, CHD, PAF etc, and I’m too old now to do everything longhand. The gist of my comments contained the relevance.
Statistics like the one you mentioned are usually accurate when applied to a whole population. They generally cannot identify those individuals within the population who will succumb to the outcome. There are too many confounding factors. The longer you live, the longer you are going to live. A brief look at a life expectancy chart and a bell curve will confirm this. That said, I recently read that AI can accurately and consistently identify life expectancy to within a month if sufficient personal information is submitted.
I live in ‘sheltered housing’ which consists of a block of flats with a manager, an emergency call system, a general heating system, supermarket next door etc.It’s very sociable as well and I’m sure that also helps but I have noticed the building is mostly full of people over eighty and several around 90, all of us living more or less independently. But I think part of our longevity is down to just having got to 80 in reasonable health in the first place, it seems that with reasonable care such people go on and on! I hope…..
I have not been told anything and quite honestly l wouldn’t want to know or be interested.
I think us A Fibbers should take everyday as it comes, take the treatments that are available, live life to the full, as much as we can and, be grateful that we don’t have a terminal illness. Life is short anyway, we don’t have control over our destiny so why worry about it. Think of nice things.
I concur, and that is the approach I have taken. One issue, though, is whether the real likelihood of heart damage is sufficient to warrant undergoing an ablation. I have held off because the afib has not harmed my quality of life to a significant degree.
I know we can't always know what choice is best, but I appreciate the responses!
I am in exactly the same position. I have held off ablation because, to date, my quality of life is ok. I have had 7 years of paroxysmal AF and my heart is structurally sound. The decisions we have to make can be difficult, but no one knows your body like yourself. With AF there are no comparisons because of the diversity and complexity of the condition.
One also has to take into consideration age, l am 77 and what life l have left l want to enjoy some peace from this. Thankfully l am able to do this at present. I don’t want to spend the rest of my life shooting in the dark. What’s to be will be. There are far worse illnesses to have.
Frankly, I don't think anyone has a definitive answer whether 12 hour episodes of atrial fibrillation every 12 days can hurt your heart or shorten your life expectancy.
Are these asymptomatic epidodes with a normal heart rate, or do you have symptoms with an elevated heart rate? Because if the latter, it begs the question, why are you getting 12 hour episodes of atrial fibrillation every 12 days when there are strategies, pharmacological, or surgical to prevent that.
I think what is asked is are you symptomatic - i.e. are you aware of the arrhythmia, do you feel it, or asymptomatic i.e. are you unaware of it but know because you have a device like an Apple watch that records your episodes?
Symptomatic AFib is hard to live with. Asymptomatic isn't.
Yes, I agree I am a bit confused. I have read regular AF can remodel the heart (leading to heart failure) and common sense tells me also that a weak rapid heartbeat will not be good for circulation & general body maintenance.
However others including my cardiologist don't seem to flag that up focussing instead on whether the AF is psymtomatic or not as a determinant on whether to go for an ablation.
Is this another case of the many faces of AF and individual medics sticking to their own interpretation as there is no recognised one way?
Exactly. It was the correct route for you. We take whatever treatment we need and what is best for us personally, at that moment in time, to give us the best quality of life possible. It was necessary for you. Good to hear you are well. Take care.
I was in uncontrolled AF for 20 years (10 years persistent...it started in my late 20s) until aggressive treatment, couple years ago, and now in NSR. Lots of that time though my heart was over 100.There was heart remodelling and I did hit the heart failure category a few years back, but now back in NSR, I am back out of that category.
My point being that I think people worry about doing permanent damage (understandably) but it takes quite a bit I think to actually remodel the heart. Not a few episodes.
I think the narrative around AF being just a nuisance condition is really unhelpful, as it clearly can cause a lot of harm, but equally it doesn't help to live in fear of it.
I am pretty sure given the damage to my heart there will be a few years knocked off. I have a few other health conditions that probably do the same. And some of them are already debilitating and life impacting if not life shortening. So, I tend to do what I can when I can. And parallel "plan" for all eventualities in terms of work, pension, finances etc without getting hung up on that or assuming anything is a given. Way too many variables! 😊
I take Vit C tabs daily..think Dr Gupta (york cardiologist on YouTube) mentioned that it helped repair the heart muscle in rats…..well.it won’t hurt to do it, don’t know how my heart looks inside from the first and only echo 3 yrs ago when diagnosed.
I haven’t been told anything except that it was important not to be in AF over 100 for any length of time. I also think - just my own observation - that the irregularity of AF plays a part as mine usually starts quite fast and very irregular and then smooths out over time if I don’t aggravate it until I can barely notice it. But slow and very irregular is also debilitating so there are definitely different ’makes and models’ of AF and your particular one affects your personal outcome.
AF caused my heart and left atrium to enlarge which has now resulted in my being on a list for mitral valve repair surgery. The enlargement of the atrium has pulled the annulus (framework) around the valve out of shape and consequently, the valve doesn't close properly.I was in AF pretty much permanently and very symptomatic bit it's currently controlled by Amiodarone. Being back in NSR has not caused the heart to shrink back although, apparently it can sometimes. The AF sometimes isn't the problem but it causes them.
My permanent AF has caused my heart to enlarge. On my last Echo it said:left atrium moderately dilated. Right atrium moderate to severely dilated. Mild mitral regurgitation but opens well. Ejection fraction =>55%. The cardiologist says my heart is structurally fine. When I saw an EP 2 years ago he suggested Amiodarone, then cardioversion with potentially an ablation. I haven't gone down that route because of my fear of the side effects of Amiodarone so I am living with symptomatic AF treated only by beta blockers; BP meds and Eliquis. The EP said "AF won't kill you but it will impair your quality of life". Can you tell me how you got on with Amiodarone please. Especially conversion to NSR. Did that happen with Amiodarone alone or a cardioversion and or ablation.
Hi. I've been on and off Amiodarone, latest stint may be 4 years. I have had no major issues that I'm aware of. I have some vortex keratopathy which has caused corneal deposits, which they say should go when the Amiodarone is stopped.
I had ablation in 2021 but that failed quite quickly.
I have had several cardioversions, lasting up to 2 years and certainly, the Amiodarone has helped woth that.
I'm have an echo next month as its been about 3 years since the last. I've got severe MVR but my EF last time was 65%, I believe.
They are supposed to be doing a Cox IV Maze at the same time as the valve repair, to hopefully stop the AF once and for all as there's supposed to be about a 90%+ success rate.
Surgeon also mentioned reducing the size of the atrium/heart at the same time....... a sort of heart tuck. I did ask him if he could do a tummy one at the same time but I'm not sure he had much of a sense of humour. 😁
I fortunately get infrequent short bouts of AF. I read about fast and slow AF, but I find when mine starts (do not have any special equipment) - It's when I've got myself into a quite unnecessary stressed state, apart from my BP monitors, I have a finger Pulse Oximeter which if I put it on shows my HR jumping around between say 40 BPM and 150 BPM - I take 1.25mg Biso and it gradually comes down from the high point and increases from the low point, until it become a steady 70 BPM or so. The whole episode takes lasts about 4 hours. Should it happen like this, is it fast or slow AF? I apologise for asking this question on this thread, maybe I should have started my own. Please ignore if inappropriate.
I usually start around 80-100 but slow down within a half hour to 60-80. The pulse is so erratic the monitor measuring doesn't mean much. I think the low dose daily metoprolol helps avoid extreme racing when I get afib.
Thanks - I find if think my HR is fast, it's a strange feeling ! and it's gone up into the 90s and I take 1.25mg of Biso, it stops it from going into fibrillation. I am on an as needed regimen with the BB, as I don't like the side rffects - I think I'll ask my Cardiologist for a different one that i can take a very low dose of daily without feeling like something out of a horror film !
we don’t know how many years we have anyway I wouldn’t worry about what he said.
Bob is right listen to him. I have heart failure because I had six months of steady tachycardia and I’ve had tachycardia since the beginning of a fib so that definitely was going to do me in which is why I had to get the pacemaker. FYI, after I got the pacemaker, my ejection rate has gone from in the 40s to the 70s because there is not still being done. The damage was the tachycardia close to 200 my heart and I were exhausted.
I don’t worry about stuff like this because I could step out the door and get hit by a bus. If you’re gonna worry about it, you’re not gonna be enjoying life very much.
I don’t know why doctors aren’t more careful with what they say or how they say it sometimes they forget we are people and we don’t know what they do. It’s like talking to someone who is having part of the conversation in their head. They don’t say all of it so you’re only getting what they are telling you and it’s not the whole story.
Such statistics can seem meaningless when not taken within the context they were intended for, and sometimes such statistics are based on evidence that might be questionable. An elderly friend is nearly 92 and has had permanent AF (at a lowish rate) for many years. He remains well.
Aside from the increase in clotting that AF causes, the issues around it, so far as I know, are what, if anything, it is doing to the ventricles (for example, speeding them up too much and for too long. risking weakening them). Also, AF in a heart that has any other issues with the ventricles, such as any kind of heart block or whatever. Some people's AF drops their heart output too far, too, which makes them very symptomatic. That might not affect the heart, even over the long term, but it might not be easy to cope with.
I think the differing views of your doctors reflect no more than the lack of certainty concerning prognosis. AF can be a product of an ageing heart and a none-too-healthy lifestyle so producing statistics must be very difficult given the many confounding factors at play.
just looking at your message again so what is your Cardiologist plan to do about it if he’s so concerned? I would say follow the lead of your EP if he’s a good one I’m starting to lose faith when it comes to my just remember they are the plumbers EP is the specialist when it comes to a you really feel unhappy with get a second opinion. I just recently had something with my that made me see he just doesn’t know what he doesn’t know when it comes to things like my pacemaker. If they were all that good, they wouldn’t need an EP.
relax because the anxiety will make you feel bad sometimes we listen to too many people and you know what they say about too many cooks in the kitchen
I have been told the same but my out look is this- No two people are the same. We are trying the best we can to mange this concern and to me these statistics are arbitrary at best. I go home when I go and Im okay with it. I don’t encourage death, rather embrace it. Just my opinion.
statistics DO NOT apply to individual cases…such numbers are derived from population samples, frequently small samples. Your EP has the right attitude!
I wouldn't pay any attention to stats like that. We probably lose more time than that waiting for buses, trains, telephone queues and filling in forms!
If a few years are taken from your life due to a condition like AF, but you’re able to live well and maintain some function, you’re lucky. If the alternative is years of severe, poor health or progressing dementia, then perhaps having those years taken off isn't so bad. Quality of life as they say is important.
I have persistent afib and often spend months in afib. When I’m in afib I take beta blockers and my heart rate in afib is in the 60s. The only way I can get out of afib is a cardioversion and they don’t typically last long. I have yearly echocardiograms and my heart is fine. Both my EP and cardiologist aren’t concerned about heart damage at this point. I’m waiting for an ablation.
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